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RACISM

Opinion: The Swedish discrimination that dares not speak its name

Until Sweden addresses discrimination honestly, integration debates will remain superficial, writes journalism professor Christian Christensen, after the Dagens Nyheter newspaper exposed how medical staff allow patients to pick only 'ethnic Swedish' doctors.

Opinion: The Swedish discrimination that dares not speak its name
An article by Swedish newspaper Dagens Nyheter exposed how medical staff promised patients they could get 'light-skinned' doctors to treat them. Photo: Cleis Nordfjell/SvD/TT

Few things damage the national self-image, while at the same time generating impassioned defenses of the national good, like accusations of structural discrimination.

While racism, sexism and xenophobia at the individual level are often explained away as personal failures or “exceptions that prove the rule”, evidence of clear and sustained discrimination within public and private social institutions speak to a broader and deeper acceptance of bigotry. It cannot be waived away as some random bad apples spoiling the national barrel.

Over the past few weeks, the issue of structural discrimination in Sweden has been a topic of heated debate.

Two weeks ago, police officer Nadim Ghazale spoke at length on Swedish Radio about his professional experiences. In his talk, Ghazale recounted being asked by colleagues if, because of his immigrant background, he was a “quota hire”. In other words, he was hired simply to increase diversity. Ghazale noted that being an immigrant or a woman in the Swedish police meant having to work even harder to prove yourself to white, male colleagues. And, he continued, “if you are white, Swedish, straight and male – then you are already part of the quota. Congratulations, you got the simplest route.”

The proposal that white, straight, male Swedes have an easier time professionally was met with backlash. Conservative pundits and politicians, as well as large numbers of social media users, denied the existence of structural discrimination in Sweden. Every country has racists, they argued, but the suggestion that Sweden was, and is, anything other than a largely colour-blind meritocracy is simply incorrect. One politician from the Moderate Party even tweeted that it was “white, Swedish men” who had built the nation with their “blood and sweat”. He later deleted the tweet.

Only a few days after the national debate about Ghazale’s comments, Sweden’s Dagens Nyheter newspaper published an explosive story detailing widespread structural discrimination at public and private medical and dental offices throughout Sweden. After multiple cases of patients refusing to be treated by non-white staff had been exposed, the newspaper decided to do an investigation into how such requests were handled at the national level. For the piece, journalists called local medical offices posing as patients who had just moved into the area.

In the call, the “patients” said that they wanted to have “ethnic Swedish” doctors and dentists treating them. Disturbingly, in over half of the cases where there was diversity in the available staff, medical and dental offices went along with these clearly racist requests, promising callers that they could get “ethnic Swedish” or “light-skinned” professionals to treat them, or giving them advice on how to avoid staff who did not fit their demands.

As disturbing as they are, Ghazale’s personal experiences in the police and the Dagens Nyheter story are nothing new. Back in 2018, Swedish Television did a story about the racist treatment of staff at Swedish pharmacies, and how many of the managers either refused to condemn, or openly enabled, racist comments and requests from customers. Despite these repeated stories from staff members working across multiple industries, the denial at the national level about the extent to which structural discrimination exists is marked.

Most importantly, of course, these stories point to a broad acceptance of racism and discrimination that must be confronted openly. But, these stories also speak to other key issues so often discussed in Swedish politics and society: namely “quotas” and “integration”.

One of the most common criticisms levelled against efforts to bring more diversity into Swedish organisations and businesses via hiring practices is that such efforts go against the ideal of a society based solely on “merit.” That argument, however, is based on the myth that candidates with minority backgrounds are somehow less qualified than non-minority candidates. It is also based on the myth that the professional playing fields are equal for all employees, regardless of skin colour or ethnic background.

As the Dagens Nyheter story illustrated, staff members at medical offices were literally giving potential patients advice on how to avoid non-white doctors and dentists. Under these circumstances, it is naïve to think that the professional playing field is not tilted dramatically in favour of the white doctors and dentists in those offices. And, it is equally naïve to think that such practices do not exist in many other areas of Swedish professional life.

Over and over we hear the phrase “failed integration” in relation to immigrant communities in Sweden. In most cases, however, this failure is explained as the result of poor policy, poor effort on the part of immigrants or a combination of both. Again, the stories presented in this article point to a third, under-discussed factor impacting integration: discrimination. Even when immigrants to Sweden (or their children) are well-educated and eager to enter the workplace, they face discrimination solely on the basis of their name or appearance. This reinforces the idea that, no matter what these residents and citizens do, they will never be accepted as full, equal members of Swedish society.

As Sweden approaches elections in 2022, the issues of discrimination and integration will take more and more space in public debates. Integration, most often presented as one-way, is actually a two-way street. Until the issue of structural discrimination is addressed openly and honestly, however, such debates will remain at the superficial and self-serving levels.

Christian Christensen is a professor of journalism at Stockholm University in Sweden.

Member comments

  1. It’s really hard to get into medical and dental school in Sweden, and in North America.
    But not in many foreign lands where medical school spots go to those with connections, political or otherwise, and those who pay. So, given this, it’s possible to wonder if people are requesting local doctors and dentists based on their impressions of the underlying training and qualifications – and they are using skin tone as a proxy or marker. If so, then it is possible such requests aren’t so much about race, but are perhaps more about underlying assumptions of skill and training.

    Thoughts on this possibility?

    1. “If so, then it is possible such requests aren’t so much about race, but are perhaps more about underlying assumptions of skill and training”.

      And so the reinforcement of common tropes regarding race continues. Even if true, your comment ignores the reality that there exists a Swedish Medical Association which regulates and issues licenses for medical practitioners from other countries who wish to practice in Sweden. Such an organisation would also probably take care of reports of malpractice and strike off any medical professional who did not meet standards of practice and ethics which were required for the country.

      In my home country, UK, doctors and nursing staff come from all corners of the world and in the main are valued enormously for the contribution they make to caring for patients. We are all the more better for it and many of our highest regarded surgeons are not of “White British” ethnicity. Swedish people may need time to adapt and come round but to make excuses like they have judged professionals from other countries to be less capable is a poor show that only reinforces racism.

      Those are my thoughts.

    2. There are many more objective proxies for competence (grades, certificates, university ranking, years of experience…); if a patient cannot ask for a doctor using any of those proxies, how are they allowed to use a proxy solely based on their presumptions on what is happening in foreign lands?
      In Iran for example, it is actually quite difficult to get into medical schools, there’s a central exam for the universities and only ~2% of the (~500,000) participants manage to get into a medical program.

      1. Hi,

        I agree that there are other and perhaps more effective proxies, as you suggest.

        But all I’m suggesting – and I know you guys are having troubles with this – is that Swedes might not be raging racists. And that they might have other, and perhaps even reasonable, intentions when requesting a “local doctors” over foreign doctors.

        And with regards to med school admissions, you’ve named Iran as a country that where med school admissions are difficult. This might be true, and probably is true. But I could respond by naming dozens of nations where medical school admissions is a joke, and acceptance to med school is little more than recognition that you are a member of the middle class or upper classes and that you either know someone, or that your parents can pay the tuition fees.

        In fact, I know numerous Canadians and Americans who were rejected from med school Canada and the United States (they weren’t even remotely close to securing a spot), and who then attended med school abroad. Their parents could afford to pay the high international tuition fees.
        I don’t know about you – but I’m apprehensive about letting Jeff Spicolli (lead character in fast times at Ridgemont High) perform surgery. But it happens all the time.

        And with regards to proxies – I agree that the university attended is a good indicator.
        When in my home nation, for example, I will often casually ask my doctors what med school they attended. I want to know if it was a top med school, or a low-tier. But my decisions after that depend on the procedures required. If they are treating me for something minor, a small skin rash for example, I wouldn’t worry much about the answer. But if I have a serious issue, and I required something such as eye surgery or perhaps abdominal surgery, I’d like a doctor who attended a top med school. There is a reason why people make a big fuss about the Mayo clinic, Harvard Medical school, Columbia medical in New York etc. In Canada, I would look for graduates of the University of Toronto, Queens University, and of course McGill University in Montreal – top medical schools with high admission standards vs. some other universities.

        But, I should note, it is very hard for your average and every day citizen to differentiate between one foreign nation and another (iran vs. the Dominican Republic for example). And they certainly wouldn’t know the reputations of the universities in all the different countries, and the admissions policies. And with this, I again suggest that it is possible that many Swedes may sometimes use race as a proxy for something else – qualifications and skill – and that perhaps Swedes are not the big bad racists that the article and you seem to be suggesting. In fact, when taken within this context, their requests might be at least somewhat reasonable.

    3. Hi Jack,

      I agree with you, racism is not necessary an issue here. Being an immigrant myself, I am tired to hear that Swedes are racists during all these years I have lived in Sweden. Swedes have a lot of cultural and other issues that I really do not like but to call them racists is a way too much. It has become popular to blame other people when you fail than to seek what can be wrong in what you do.

      Regarding some patients’ requests to have ethnic Swedish doctors – it might be many reasons to it not necessary connected to racism. One of them is the language. My first years in Sweden were very hard like for any immigrant. I remember when I worked as personlig assistent for an old Swedish man with physical disabilities and severe health problems. My Swedish was not as fluent as it is now, he talked quietly and not that clear that I could understand everything. Very often I had to ask two or three times to repeat what he was telling to me. Myself I was afraid that if something happened to him I would not even understand what he needs and how to deal with that. Would it be right to call him racist if he asked for an ethnic Swede to take care of him? I don’t think so. It is important to understand that he also wants to feel secure with people around him and to be sure that these people understand what he needs.

      Let’s be fair, many immigrant doctors do not speak as good Swedish as it might be necessary. A couple of months ago I visited a doctor whose Swedish was ok for basic conversation but all the time I felt that she didn’t get what I was asking her as her answers were not really about my questions but something different. Moreover, sometimes I had to ask her to repeat because of her heavy accent. That moment I just wanted to go to a Swedish doctor. Strange enough for me as I even do not trust Swedish doctors because of really bad experiences in the past. I think that the Swedish health care system is very poor in competence and of low quality. Only people with minor health problems or problems that represent a “standard” case for the Swedish system can appreciate health care in Sweden. All my serious problems were just ignored here, and I had to go abroad to seek reliable medical help. I will not even mention ridiculously long queues and no possibility to choose a doctor.

      When I saw who wrote this article above… well… no wonder why we have one-sided journalism in Sweden.

  2. True, It’s hard to get into medical schools in Sweden. It is also not that easy to become a medical professional in Sweden if have a medical degree from another country. It is a long process starting with learning Swedish, clearing medical exams, working under the supervision of a senior doctor, and only then you would eventually become an independent professional who would be allowed to, for example, prescribe medicines. So basically, the immigrant doctors have to study medicine twice – first in their home country and then here in Sweden. If some people use race as a proxy for competence etc., then they clearly don’t understand what immigrant doctors have to go through to become approved professionals in Sweden. But I don’t think this is the issue in all the cases in the DN story. The author has rightly pointed out that integration is not a one-way street. All the onus is not on immigrants. It seems as if people are not even willing to accept that immigrants face discrimination in Sweden. Such attitudes are one of the reasons that the integration debate will just remain a one-sided debate without any real progress.

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OPINION & ANALYSIS

Gothenburg: is the dream of a new city turning into a nightmare? 

Sweden’s second city is the site of Scandinavia’s largest urban development project. But there is rising concern that the costs outweigh the benefits, says David Crouch

Gothenburg: is the dream of a new city turning into a nightmare? 

Last week, residents in the area of Fågelsången (birdsong), a quiet street at the very heart of Sweden’s second city, woke up to read the following news: “Explosions at Fågelsången: On August 8, week 32, we start blasting around Fågelsången and are expected to be done by week 40. When blasting, for safety reasons, no one is allowed to go out, open their windows or be within the blasting area. We will work weekdays 7am to 5pm.” 

Blasting deep holes in the granite – along with sprawling roadworks – has been the reality for central Gothenburgers for the past four years, as a vast rail tunnel is being dug to link the current terminus with other parts of the city and enable smoother connections with other routes. The aim is to triple rail passenger numbers and eliminate traffic jams on the main road through the city, at a cost of 20 billion crowns (€1.9 billion).

This railway, known as Västlänken (the West Link), is not the only big construction project in the city centre. It is just the largest element in a gigantic scheme to revive the docks area along the river, which was destroyed by a global shipping crisis in the 1970s. The great rusting cranes opposite the opera house and the disused Eriksberg gantry are an important aspect of Gothenburg’s skyline and self-image. The areas on the north bank were also home to many recent immigrants and a byword for poverty. The city’s mayor famously, and shamefully, referred to it as “the Gaza strip”.

So in 2012 the city launched an ambitious plan. Christened Älvstaden, the RiverCity, municipal investment aimed to build an attractive, modern waterfront while creating tens of thousands of homes and jobs. It is by far the Nordic region’s biggest urban regeneration project. A YouTube video commissioned by the city authorities a few years later neatly sums up both the breathtaking scope of this vision and the exciting / brutal (choose your own adjective here) nature of the transformation it would bring: 

The RiverCity revolved around two flagship projects: a new bridge over the river, the Hisingsbron (Hisingen Bridge), combined with major new office developments right in the centre; and Karlatornet, Sweden’s tallest skyscraper, which would literally tower over Gothenburg like a beacon of modernity in a city that traditionally has had strict rules against high-rise buildings. 

Add to all this a proposed high-speed rail link with Stockholm, and you have a recipe for quite spectacular urban upheaval involving billions of tons of steel and concrete. Visit Gothenburg today and much of the city seems to have been turned into a building site. There is a forest of cranes, while smart new office blocks puncture the skyline – a genuine metamorphosis is under way.

But many Gothenburgers are either uneasy or downright unhappy. The RiverCity is a vanity project to gentrify the docklands, they say. Karlatornet’s 73 stories of luxury apartments will be a scar on the landscape and a symbol of Gothenburg’s new love affair with finance and real estate, a slap in the face for the city’s proud industrial values. Västlänken is a vit elefant, a costly project that will deliver questionable benefits, many believe.  

Opposition to Västlänken was such that a new political party, the Democrats, took 17 percent of the vote in 2018 with its headline demand to stop the project immediately. This caused a revolution in local politics, overturning decades of Social Democrat rule. 

And now the gloss on these big-ticket construction projects is starting to fade. Karlatornet was the first to run into trouble. For most of 2020 building work was at a standstill, raising the threat that this flagship of regeneration would be nothing more than an unfinished stump, after American financiers pulled out of the project. The new Hisingen Bridge is open to traffic, but its construction was fraught with setbacks and the final cost to the taxpayer is still unknown. “There has been an awareness from the start that this was a high-risk project,” one of the project’s bosses said ominously this spring.

RiverCity is more than two billion kronor over budget, and facing accusations of mismanagement that evoke Gothenburg’s old nickname of Muteborg, or Bribetown, after a proliferation of municipal companies in the 1970s led to conflicts of interest, with politicians sitting on company boards. Opponents of the scheme argue that in any case it is unlikely to solve any of the city’s fundamental problems, such as the ethnic segregation that has created immigrant ghettos in outlying suburbs.  

In May, Swedish newspaper Dagens Nyheter published leaked minutes from Västlänken management meetings in which one of the main contractors on the project said it would be delivered billions over budget and four years later than its official 2026 deadline – in other words, four more years of earth-shattering explosions, roadblocks and associated upheaval. With local elections only months away, the Democrats have taken out advertisements on billboards and in local media demanding that top politicians tell the truth about what is going on. For opponents of the scheme, this is exactly what they have warned of all along

Next June, Gothenburg will officially celebrate its 400th anniversary, postponed from 2021 because of the pandemic. Visitors will experience a city on the move, with pristine new motorways and sparkling office blocks. So for Gothenburg’s urban planners, there is light at the end of the development tunnel. In the case of Västlänken, however, they will be hoping that the light is indeed that of an oncoming train. 

David Crouch has lived in Gothenburg for nine years. He is the author of Almost Perfekt: How Sweden Works and What Can We Learn From It, a freelance journalist and lecturer in journalism at Gothenburg University.

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